For Your Child

Kids Suffer Early On from Secondhand Smoke

Secondhand smoke causes signs of cardiovascular damage in children, especially the very youngest, say researchers at an American Heart Association (AHA) meeting.

The findings, which focused on children ages two to 14 years old, showed that environmental tobacco exposure (secondhand smoke) caused increased markers of inflammation and signs of vascular injury, suggesting an increased risk of heart disease.

The youngest children appeared to be more affected than teens.

"Toddlers are smokers by default," says one of the study's authors, John Bauer, Ph.D., at Nationwide Children's Hospital and Research Institute in Columbus, Ohio.

"Forty percent of toddlers in our study had nicotine content that in adults would suggest that they were active smokers," he says. "But, an active smoker has a filter on cigarettes. The toxicity from smoke that is inhaled in the atmosphere is worse because there's no filter."

Toddlers Live in a Smoking "Fishbowl"

Dr. Bauer and his colleagues took hair and blood samples from 125 children. Fifty-seven were between the ages of two and five; 68 were between nine and 14.

Hair samples were used to measure nicotine exposure, and blood samples were used to look for a type of cell called an endothelial progenitor cell (EPC). These cells replenish the endothelium (the lining of the blood vessels) and provide clues to levels of cardiovascular health.

The researchers also asked the parents how many smokers children had been exposed to in a 24-hour period.

Children in the youngest age group had almost six times the average nicotine levels than older children did.

Toddlers had an average nicotine level of 12.68 nanograms per milligram of hair, while older kids had an average level of 2.57 nanograms per milligram.

"Toddlers were more exposed," notes Dr. Bauer. "Toddlers are like fish in a fish bowl. They're strapped pretty closely to their parental units, which exposes them to more smoke than adolescents who live in the same set of circumstances."

"Toddlers also breathe more rapidly, so they inhale more," adds co-author Dr. Judith Groner, a pediatrician.

The youngest children also had higher levels of an inflammatory marker called soluble intracellular adhesion molecules, and there was an inverse relationship between EPC levels and exposure to smoke in both age groups, though again, the effect of secondhand smoke was more pronounced in the younger children.

These findings are similar to what has been found in adult smokers, according to the study authors. EPC levels have not yet been studied in adults exposed to secondhand smoke.

"Based on markers of vascular stress, toddlers are hit harder," explains Dr. Bauer. "To what extent this is reversible if exposure is stopped isn't known.

"In adults, there is evidence that when active smokers quit smoking, the risk of heart disease is lower, but some research suggests that cardiovascular disease may be imprinted in early life, so we don't know if this is reversible or not," he says.

Quit Smoking or Go Outside to Smoke

Dr. Devang Doshi, director of pediatric pulmonology, allergy, and immunology at Beaumont Hospital in Royal Oak, Michigan, says, "This study gives us more insight into the bad effects of secondhand smoke exposure from a respiratory and cardiac standpoint."

"A lot of people don't realize that when you smoke in the house, children are continuously exposed," he adds. "It's always in the house; the smoke doesn't just go away."

Dr. Doshi says his first advice to parents is to quit smoking. Failing that, he says he advises parents to go outside, away from the house to smoke, and to wear at least two layers of clothing.

Then, when they come back in the house, he recommends removing the top layer of clothing and washing their hands to try to limit their child's exposure.

"Don't smoke," advises Dr. Groner, "and have a total ban on smoking around your child."

Always consult your physician for more information.

Online Resources

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Children and infants exposed to tobacco smoke are more likely to experience ear infections and asthma, and are at a higher risk for sudden infant death syndrome (SIDS) than children and infants without the same exposure.

Smoking has been classified as the single most preventable cause of premature death in the US.

According to the AHA, eliminating smoking not only reduces the risk of coronary heart disease, but also reduces the risk of repeat heart attacks and death by heart disease by 50 percent. Research also indicates that smoking cessation is crucial in the management of many contributors to heart attack, including atherosclerosis, thrombosis, coronary artery disease, and cardiac arrhythmias.